1. Field of the Invention
The invention relates to surgical procedures, and, in particular, to the attachment of soft tissue to other tissue or the attachment of objects to soft tissue.
2. Description of the Related Art
The securement of soft tissue segments together has conventionally been done using suturing or stapling devices. However, when attaching segments of soft tissue together that are exposed to tension post-operatively, such techniques often do not hold up over time. This is particularly true for segments of the gastrointestinal (GI) tract. For example, when performing a gastric restriction procedure, such as gastroplasty, simply sewing the anterior and posterior walls of the stomach together often does not hold up over time. Part of the reason for this is that the lining of the stomach does not tend to grow across the sewn seam, as is often the case for other types of tissues and organs when sewn together. Also, with a gastric restriction in particular, the sewn seem is subject to significant stresses post-operatively, when patients try to eat more food than can fit into the reduced stomach compartment created by the sewn seam.
Multiple rows of staples tend to hold up better in these types of applications, not because they grip the tissue better, but because they tend to cause a band of tissue necrosis that induces scarification across the walls of the stomach. Such stomach stapling procedures hold up even better when the stapled tissue is cut along the midline of the multiple rows of staples. Cutting the tissue tends to trigger a wound healing effect that leads to wall-to-wall scarification.
Such multiple-row stapling and cutting of tissue is often neither practical nor desirable, as in the case of flexible endoscopic or endoluminal surgery, where such procedures would be difficult and dangerous. Further, in certain types of elective surgery, such as gastric restriction, it may be desirable to have the procedure be reversible, and reversibility is difficult after tissue has been stapled and cut.
Additionally, when attaching a foreign body to a segment of soft tissue using attachment techniques such as suturing, if the foreign body is subject to forces postoperatively, the foreign body will typically pull loose from the tissue segment.
There is, therefore, a need for robust tissue securement devices and methods which enable tissue-to-tissue attachment and attachment of foreign bodies to tissue with less chance of detachment occurring post-operatively if the securement devices are placed under tension. Moreover, there is a need for robust tissue securement devices which can be delivered endoscopically, as through a rigid endoscope, or endoluminally, as through a flexible endoscope. There is a further need for anchoring devices that enable reversible attachment of tissue-to-tissue and foreign bodies to tissue, and which do so safely with respect to adjacent anatomy.